| Entity Name: | BEATRIZ L. VILLAFANE, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Jun 2003 (22 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 19 Nov 2020 (4 years ago) |
| Document Number: | P03000069325 |
| FEI/EIN Number | 651194101 |
| Address: | 17900 NW 5th Street, Pembroke Pines, FL, 33029, US |
| Mail Address: | 15460 NW 83rd Place, MIAMI LAKES, FL, 33016, US |
| ZIP code: | 33029 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427399153 | 2013-03-05 | 2015-05-13 | 15460 NW 83RD PL, MIAMI LAKES, FL, 330165836, US | 735 COMMERCE CENTER DR, SUITE A, SEBASTIAN, FL, 329583136, US | |||||||||||||||||||||||||||
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| Phone | +1 786-202-0246 |
| Fax | 9544431989 |
| Phone | +1 954-443-1988 |
Authorized person
| Name | DR. BEATRIZ LILIANA VILLAFANE |
| Role | OWNER |
| Phone | 7862020246 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME86717 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 266472100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Villafane Eduardo | Agent | 15460 NW 83rd place, Miami Lakes, FL, 33016 |
| Name | Role | Address |
|---|---|---|
| VILLAFANE BEATRIZ L | President | 15460 NW 83rd Place, Miami Lakes, FL, 33016 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000038105 | CORNERSTONE PSYCHIATRIC CENTER | ACTIVE | 2013-04-20 | 2028-12-31 | No data | 17900 NW 5TH STREET, SUITE 203A, PEMBROKE PINES, FL, 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2020-11-19 | Villafane, Eduardo | No data |
| REINSTATEMENT | 2020-11-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-11 | 15460 NW 83rd place, Miami Lakes, FL 33016 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-11 | 17900 NW 5th Street, Suite 203A, Pembroke Pines, FL 33029 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-11 | 17900 NW 5th Street, Suite 203A, Pembroke Pines, FL 33029 | No data |
| AMENDMENT AND NAME CHANGE | 2010-12-14 | BEATRIZ L. VILLAFANE, MD, PA | No data |
| REINSTATEMENT | 2010-07-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| REINSTATEMENT | 2005-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-01-20 |
| REINSTATEMENT | 2020-11-19 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-03-18 |
| ANNUAL REPORT | 2016-01-18 |
| ANNUAL REPORT | 2015-03-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
